Respiratory Changes During Carbon Dioxide Pneumoperitoneum

Abstract

In contrast to conventional surgery laparoscopic procedures are considered to be minimally invasive. Initially, laparoscopies were of brief duration and were usually performed on otherwise healthy gynecologic patients [1, 2]. Since the improvement of laparoscopic techniques more extended procedures have been performed. The patient population undergoing laparoscopic intervention has also significantly changed. The amount of high-risk patients with cardiopulmonary impairments has increased. When performing laparoscopic surgery, a carbon dioxide pneumoperitoneum is usually established. Experiments have shown that carbon dioxide insufflation into the peritoneal cavity and the subsequent increase in intra-abdominal pressure results in significant respiratory changes due to hypercapnia and diminished alveolar ventilation in the lower lung lobes. Pathophysiological aspects of increased carbon dioxide absorption, as well as aspects of respiratory changes, especially in patients suffering from chronic pulmonary diseases, and the role of positive end-expiratory pressure application will be elucidated.